Multiple Becker's Nevi in a Female Patient Without Musculoskeletal or Developmental Abnormalities: A Case Report and Review of the Literature.

Becker's nevus (BN) is one of the cutaneous hamartomatous lesions that often presents as an acquired, single unilateral pigmented hairy patch on the upper trunk, scapular region, or upper arm. Hereby we introduce a 13-year-old girl with the unusual manifestation of BN with multiple acquired, pigmented hairy patches for six months without any musculoskeletal or developmental involvements. After carefully reviewing the literature, to the best of our knowledge, this is the first case in this regard in Iran.

High-sensitivity C-reactive protein as a biomarker in detecting subclinical atherosclerosis in psoriasis.

Psoriasis is known to be associated with increased risk of cardiovascular diseases. High-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation and an independent risk factor for atherosclerosis. We aimed to assess the correlation between hs-CRP and subclinical atherosclerosis in psoriatic patients. In 60 patients with moderate to severe psoriasis and 60 age- and gender matched healthy controls, we evaluated the serum hs-CRP level and mean intima-media thickness of the common carotid artery (MIMT-CCA). Psoriatic patients had higher levels of hs-CRP (median, 2.25 mg/L; IQR, 0.98-3.80; and range, 0.29-11.60) than did those in the control group (median, 1.03 mg/L; IQR, 0.36-2.15; and range, 0.10-3.35). Psoriatic patients also had higher mean MIMT (0.74 ± 0.19 and 0.54 ± 0.12, respectively, and P < .0001) compared with healthy subjects. The serum level of hs-CRP was significantly correlated with MIMT (P < .0001). Our results indicate that psoriatic patients have a higher risk of subclinical atherosclerosis and hs-CRP may be a useful marker for future risk of cardiovascular diseases in these patients. So, not only does anti-inflammatory drugs play a key role in the treatment of psoriasis, but also they may reduce the risk of cardiovascular diseases by decreasing level of inflammatory markers including hs-CRP.

Vascular Changes in Eosinophilic Esophagitis (EOE), Report of an Unusual Case.

Background: Submucosal or lamina propria arteries are not often included in esophageal biopsies. We report an esophageal biopsy with eosinophilic esophagitis (EOE) overlying small arteries with medial hypertrophy to the point of obstruction. Case presentation: A two-year-old boy with a 1-year history of asthma frequently vomited after coughing. Esophageal biopsy showed EOE. Within the lamina propria there were small arteries with markedly thickened media to the point of luminal obstruction next to a hyperplastic lymphoid aggregate. There was no significant inflammatory infiltrate in the arterial walls. Subsequent biopsies did not show these vascular changes. Conclusion: Small artery changes in EOE have not previously been reported, and although the significance is unknown, in this case may be incidental to eosinophilic esophagitis.

Malakoplakia in Association with Adenocarcinoma of Sigmoid Colon; A Case Report.

Malakoplakia is a rare granulomatous disease of the genitourinary system. Gastrointestinal tract is the second most common site of involvement. It usually mimics a malignancy but its association with adenocarcinoma has been rarely reported. A 59-year-old male patient with the history of weight loss and rectal bleeding for two months prior to administration was referred to our hospital. Pre-operative CT scan revealed a large sigmoid colon mass with the extension and invasion to the serosal surface as well as multiple regional metastatic lymph nodes. The patient underwent sigmoidectomy with the primary pathologic diagnosis of adenocarcinoma. Pathologic examination revealed a moderately differentiated adenocarcinoma invading peri-colic adipose tissue and inflammatory reaction compatible with malakoplakia at the invasive borders of the tumor with the extension to the serosal surface. In the patients with gastrointestinal malakoplakia, the presence of possible adjacent malignancy should be screened. The possibility of over-staging should also be considered for adenocarcinoma cases in association with malakoplakia.

Can serum level of N-terminal pro B-type natriuretic peptide be used in patients with psoriasis as a predictor of cardiovascular disease?

Past studies have reported associations between psoriasis, metabolic syndrome, and atherosclerotic cardiovascular disease. According to studies, N-terminal pro B-type natriuretic peptide (NT-proBNP) is a useful screening test for cardiac disease. We examined the serum NT-proBNP level in patients with psoriasis and compared them with nonpsoriatic healthy control subjects. Sixty-one patients with psoriasis were enrolled, along with 61 age, sex, and body mass index (BMI) matched control subjects. In both groups, NT-proBNP serum levels and lipid profile parameters were investigated. Means and 95% confidence intervals (CIs) were reported. The median serum concentration of NT-proBNP was higher in psoriatic patients than the control group (26.67 [interquartile range (IQR): 15.15-43.03 and range: 5-250] vs. 17.45 [IQR: 12.35-20.80 and range: 5-45.09, p < 0.0001). NT-proBNP serum level in psoriatic arthritis patients (11%; 55.6 ± 25.7 pg/mL, 95% CI: 31.9-79.4 pg/mL) was higher than psoriasis patients without arthritis (35.8 ± 40.6 pg/mL, CI: 24.7-46.9, p < 0.001). NT-proBNP levels were also positively correlated with BMI, lipid profile, and disease duration. NT-proBNP is elevated in patients with psoriasis, consistent with the high risk of cardiovascular disease associated with psoriasis.

Infantile hypopigmented pityriasis versicolor: two uncommon cases.

Pityriasis versicolor is a common infection of the epidermis in adults, but only a few cases of this infection (especially the hypopigmented type) have been reported in infants aged under one year. Herein, we document a report of these cases and a review of the literature. Two patients with infantile pityriasis versicolor, who presented with hypopigmented macules on the neck, upper back, and chest are reported. A KOH examination was suggestive of pityriasis versicolor and our patients responded well to 1% clotrimazole lotion (twice a day) for four weeks. Pityriasis versicolor should be considered in the differential diagnosis of hypopigmented macules and patches in infants.

Coexistence of mucous membrane pemphigoid, vitiligo, and hypothyroidism: A second report of a new multiple autoimmune syndrome.

Mucous membrane pemphigoid (MMP) is a rare immunobullous disease affecting the mucous membrane and skin. An association of MMP with other autoimmune disease is uncommon. Multiple autoimmune syndrome (MAS) is a subclass of autoimmune disorders with a coexistence of three or more autoimmune disorder in a single patient. The second report of the association of vitiligo, autoimmune thyroid disease, and MMP shows that this combination can be considered as a new type of MAS, although its mechanism and pathology are unknown.

Peripheral T-Cell Lymphoma Presenting as a Primary Uterine Cervix Mass: A Report of a Rare Case.

Malignant lymphoma is a rare form of malignancy in the uterine cervix. Most of the previously reported cases were B-cell lymphomas. We present a case of primary peripheral T-cell lymphoma, not otherwise specified, in the uterine cervix in a 49-year-old woman with a history of severe vaginal bleeding. The patient was treated with a CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) chemotherapy regimen and 28 cycles of radiotherapy. Three months later, she presented with generalized lymphadenopathy and sudden left-eye ptosis as a complication of CNS involvement and died after 20 months from the initial disease presentation.